{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:27:25Z","timestamp":1786944445431,"version":"build-2736575974"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatoduodenectomy is associated with postoperative complications in nearly half of all patients. Understanding the financial burden of these complications is relevant to supporting initiatives to improve patient outcome and resource allocation. A contemporary systematic review evaluating the costs of complications following pancreatoduodenectomy is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted following PRISMA 2020 guidelines in PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to September 2024. Studies reporting on the hospital costs (primary outcome) of complications following pancreatoduodenectomy were included. Costs were adjusted for inflation and purchasing power parity to 2023 Dutch euros (\u20ac). Data extraction and risk-of-bias assessments were conducted independently by two reviewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 46 studies with 111 215 patients undergoing pancreatoduodenectomy from 13 countries were included. Postoperative pancreatic fistula grade B increased costs by \u20ac1998 to \u20ac25 228, and grade C by \u20ac21 268 to \u20ac112 824 versus no clinically relevant postoperative pancreatic fistula (mean or median values). Delayed gastric emptying grade B increased costs by \u20ac10 836 to \u20ac22 571 and grade C by \u20ac28 707 to \u20ac61 818 versus no clinically relevant delayed gastric emptying. Postpancreatectomy haemorrhage (various definitions) increased costs by \u20ac29 447 to \u20ac48 380. Biliary leak grade B increased costs by \u20ac7616 and grade C by \u20ac22 727. Clavien\u2013Dindo complication grade III added \u20ac2785 to \u20ac20 294 compared with grade II, and grade IV added \u20ac25 190 to \u20ac63 644 compared with grade III.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Complications following pancreatoduodenectomy increase costs substantially, exceeding \u20ac100 000 for a single postoperative pancreatic fistula grade C. These costs can now be used to design cost-effective prophylactic and therapeutic interventions aiming to improve patient outcomes together with optimal use of healthcare resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag055","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:33:28Z","timestamp":1777980808000},"source":"Crossref","is-referenced-by-count":0,"title":["Hospital costs associated with complications following pancreatoduodenectomy: systematic review"],"prefix":"10.1093","volume":"10","author":[{"given":"Michiel F G","family":"Francken","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, Location University of Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joey","family":"de 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